| NPI | 1639122690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2086S0129X |
| 208800000X Urology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 208600000X Surgery | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 207L00000X Anesthesiology | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207Y00000X Otolaryngology | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-05-03 |